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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2011, Vol. 5 Issue (3) : 288-293     DOI: 10.1007/s11684-011-0127-9
RESEARCH ARTICLE |
Type 2 diabetic patients with non-alcoholic fatty liver disease exhibit significant haemorheological abnormalities
Hui Dong1, Fu’er Lu1, Nan Wang2(), Xin Zou1, Jingjing Rao2
1. Institute of Integrative Traditional and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; 2. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Abstract  

Haemorheological abnormalities have been described in diabetes mellitus, as well as in non-alcoholic fatty liver disease (NAFLD). However, the relationship between the changes in liver fat content and haemorheology is unknown. The current study aims to show the correlation between haemorheological parameters and intrahepatic lipid content (IHLC) in patients with type 2 diabetes. The serum biochemical markers, such as fasting plasma glucose (FPG), haemoglobin A1c (HbA1c), liver enzymes, lipid profiles, and haemorheological properties, were examined. IHLC was quantified using proton magnetic resonance spectroscopy (1H-MRS) scanning of the liver. A significant correlation was observed between IHLC and whole blood viscosity at high, middle, and low shear rates. IHLC also positively correlated with haematocrit, the reduced whole blood viscosity at low and middle shear rates, and the erythrocyte aggregation index. Diabetic patients with NAFLD exhibited significant haemorheological abnormalities compared with patients without NAFLD. In summary, haemorheological disorders are linked to non-alcoholic fatty liver in type 2 diabetes.

Keywords diabetes mellitus, type 2      haemorheology      non-alcoholic fatty liver disease     
Corresponding Authors: Wang Nan,Email:southern1@sohu.com   
Issue Date: 05 September 2011
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-011-0127-9     OR     http://academic.hep.com.cn/fmd/EN/Y2011/V5/I3/288
VariablesSubjectsNormal reference ranges
BMI (kg/m2)24.6±3.218.5-24
Waist (cm)Women 83.1±7.7Women<80
Men 90.6±7.5Men<90
ALT (U/L)25 (18, 33)0-41
FPG (mmol/L)7.97±2.103.90-6.40
HbA1C (%)7.62±1.504.5-6.3
TC (mmol/L)4.98±0.992.90-5.20
TG (mmol/L)1.31 (1.04, 2.04)<1.7
LDL-C (mmol/L)2.93±0.820.00-3.12
Blood viscosity (mPa/s)
Low shear rate7.38±1.405.20-8.20
Middle shear rate4.83±0.603.80-5.10
High shear rate4.18±0.523.30-4.50
Plasma viscosity (mPa/s)1.37±0.071.20-1.45
ESR (mm/h)9 (5, 20)0-20
Blood reduced viscosity (mPa/s)
Low shear rate14.80±2.449.30-16.30
Middle shear rate8.55±0.966.00-9.10
High shear rate6.92±0.815.10-7.70
K-value of ESR27.90 (17.90, 53.77)0.00-120.00
RBC rheology
Aggregation index1.75±0.171.40-1.90
Rigidity index5.05±0.583.80-5.80
Deformation index0.89±0.050.78-0.92
Electrophoresis index4.37±0.503.50-4.60
IHLC (%)3.64 (0.82, 10.08)<5.60
Tab.1  Characteristics of the subjects
Fig.1  The relationships between intrahepatic lipid content (log scale) and (A) whole blood viscosity at low shear rate ( = 0.387, = 0.004); (B) whole blood viscosity at middle shear rate ( = 0.390, = 0.003); (C) whole blood viscosity at high shear rate ( = 0.336, = 0.012); (D) whole blood reduced viscosity at low shear rate ( = 0.334, = 0.013); (E) RBC aggregation index ( = 0.317, = 0.018) in type 2 diabetic patients.
VariablesWithout NAFLDWith NAFLD
N3124
Age (y)55.2±8.153.8±10.6
BMI (Kg/m2)23.6±2.825.8±3.2*
Waist (cm)82.4±8.788.4±6.3**
ALT (U/L)21 (16, 28)30 (25, 38)**
FPG (mmol/L)7.94±2.318.02±1.86
HbA1C (%)7.54±1.567.72±1.46
TC (mmol/L)4.72±0.955.33±0.96*
TG (mmol/L)1.15 (0.91, 1.43)2.17 (1.38, 3.32)**
LDL-C (mmol/L)2.81±0.753.10±0.89
Blood viscosity (mPa/s)
Low shear rate6.86±1.228.05±1.34**
Middle shear rate4.69±0.485.11±0.63**
High shear rate4.02±0.444.39±0.55**
Plasma viscosity (mPa/s)1.36±0.071.39±0.07
HCT (%)39.29±4.1141.54±3.27*
ESR (mm/h)12 (4, 20)9 (5, 17)
Blood reduced viscosity (mPa/s)
Low shear rate13.90±2.1115.97±2.39**
Middle shear rate8.2±0.798.90±1.06*
High shear rate6.75±0.657.15±0.96
K-value of ESR41.26 (15.78, 56.47)26.17 (18.61, 47.43)
RBC rheology
Aggregation index1.69±0.191.82±0.13**
Rigidity index4.97±0.535.15±0.65
Deformation index0.89±0.050.88±0.05
Electrophoresis index4.35±0.564.39±0.42
IHLC (%)0.99 (0.40, 2.72)11.90 (7.24, 18.91)**
Tab.2  Comparison of characteristics between diabetic patients with and without NAFLD
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